abnormal RBC morphology

Question 1

Answer 1

sphereocyte

nearly spherical

stain deeply and uniformly

no central pale area

associated with: hereditary sphereocytosis, some hemolytic anemias, transfused cells, severe burns

Question 2

Answer 2

echinocyte

(burr cell)

erythrocyte with short, evenly spaced projections usually with central pallor

associated with: uremia, pyruvate kinase deficiency, microangiopathic hemolytic anemia, neonates (esp. premature), artifact

Question 3

Answer 3

pappenheimer bodies

(siderotic granules)

iron containing granules in RBC that stain blue with Wright’s stain and occur usually at periphery of cell

associated with: splenectomy, hemolytic anemias, sideroblastic anemia, megaloblastic anemia, hemoglobinopathies

Question 4

Answer 4

Codocyte or Leptocyte

(Target Cell)

thinner than normal RBC with a peripherial rim of Hgb and a dark central area

associated with: hemoglobinopathies, thalassemia, iron deficiency, splenectomy, obstructive liver disease

Question 5

Answer 5

pappenheimer bodies

Question 6

Answer 6

basophilic stippling

basophilic granules within RBC that stain deep blue/black

assocaited with: lead intoxication, thalassemia, abnormal heme synthesis

Question 7

Answer 7

auto-agglutination

clumping of erythrocytes; outlines of individual cells may not be evident

associated with: antigen-antibody reactions

Question 8

Answer 8

Elliptocytes

cigar shaped erythrocyte

assocaited with: hereditary elliptocytosis, thalassemia major, iron deficiency anemia, megaloblastic anemia, myelophthisic anemias

Question 9

Answer 9

Dacryocyte

tear drop cell

erythrocyte shaped like a tear drop or pear; may have one blunt projection

assocaited with: primary myelofibrosis, thalassemia, myelophthisic anemia, other causes of extramedullary hematopoiesis

Question 10

Answer 10

ovalocyte

egg-shaped erythrocyte

associated with: same diseases as elliptocyte

Question 11

Answer 11

stomatocyte

erythrocyte with slitlike area of central pallor (smiliar to a mouth)

associated with: hereditary stomatocytosis, alcoholism, liver disease, Rh null phenotype, artifact

Question 12

Answer 12

Howell-Jolly bodies

fragments of nuclear chromatin remaining in cell, stain deep purple

assocaited with: splenectomy, hyposplenism, megaloblastic anemia, hemolytic anemia

Question 13

Answer 13

stomatocytes

Question 14

Answer 14

dacrocytes

(tear drop cells)

Question 15

Answer 15

Hemoglobin SC crystals

associated with: Hemoglobin SC disease

Question 16

Answer 16

Rouleaux

“stack of coins” increased proteins in patients with reouleaux may make the background of the slide appear blue

associated with: acute and chronic inflammatory disorders, plasma cell myeloma, lymphoplasmacyic lymphoma

Question 17

Answer 17

basophilic stippling

Question 18

Answer 18

Drepanocyte

(Sickle Cell)

“Crescent” Elongated cell with point on each end; may be curved or S- shaped

associated with: homozygous hemoglobin S disease, sometimes hemoglobin SC

Question 19

Answer 19

Hemoglobin SC crystal

Question 20

Answer 20

Hemoglobin C crystal

hexagonal shape

associated with: Homozygous Hemoglobin C disease

Question 21

Answer 21

auto-agglutination

Question 22

Answer 22

rouleaux

Question 23

Answer 23

Cabot Rings

reddish-purple rings that are loop-shaped or figure eight structures

associated with: myelodysplastic syndrome, megaloblastic anemia

note: rare finding, do not confuse with malaria

Question 24

Answer 24

Hemoglobin SC crystal

Question 25

Answer 25

Drepanocyte

Sickle Cell

Question 26

Answer 26

siderotic granules